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Report Links Dead Doctors to Payments by Medicare
By Robert Pear, the New York Times
July 9, 2008
Congressional investigators said Tuesday that Medicare had paid tens of millions of dollars to suppliers improperly using identification numbers of doctors who died years ago.
The government has no reliable way to spot claims linked to dead doctors, many of whom are still listed as active Medicare providers though they died 10 or 15 years ago, the Senate Permanent Subcommittee on Investigations said.
Medicare covers wheelchairs, walkers, home oxygen equipment and many other types of medical equipment. When suppliers file claims for equipment provided to a Medicare beneficiary, they normally must list an identification number for the doctor who prescribed or ordered it.
“From 2000 to 2007, Medicare paid 478,500 claims containing identification numbers that were assigned to deceased physicians,” the subcommittee said in a new report. “The total amount paid for these claims is estimated to be between $60 million and $92 million. These claims contained identification numbers for an estimated 16,548 to 18,240 deceased physicians.”
In 16 percent of these cases, the report said, suppliers used identification numbers of doctors who had been dead for more than 10 years. In one case, Medicare paid more than 2,000 claims totaling $479,000 for services provided from 2002 to 2007, even though the doctor had died in 1999.
Another doctor died in 2001, but his identification number was used in more than 3,800 claims from 2002 to 2007, with payments totaling more than $354,000.
“Scam artists have treated Medicare like an automated teller machine, drawing money out of the government’s account with little fear of getting caught,” said Senator Norm Coleman of Minnesota, the senior Republican on the subcommittee. “When Medicare is paying claims and the doctor has been dead for 10 or 15 years, you know there is a serious problem.”
The subcommittee, headed by Senator Carl Levin, Democrat of Michigan, plans to hold a hearing on the issue on Wednesday.
Herb B. Kuhn, deputy administrator of the Centers for Medicare and Medicaid Services, said he shared the concern that “Medicare is continuing to pay claims to providers who are using invalid or inactive physician numbers.”
Mr. Kuhn said his agency was taking steps intended to stop such payments. For example, it will get monthly death reports from Social Security and compare that information with its list of doctors in Medicare.
Robert A. Vito, regional inspector general of the Department of Health and Human Services in Philadelphia, said that in some cases doctors did not know that their billing numbers were being used by suppliers of medical equipment. But in other cases, he said, doctors collude with suppliers. He cited the case of a Florida doctor who received kickbacks from suppliers in return for prescribing medical equipment covered by Medicare.
The identification number for this doctor was used on nearly $8 million worth of claims for medical equipment in one year — the equivalent of more than $20,000 a day, Mr. Vito said in testimony prepared for the hearing.
Medicare has issued new identification numbers to doctors in the last two years. But, Mr. Vito said, these numbers are “readily available to the public,” so “fraudulent suppliers can easily obtain a valid number” and use it on their Medicare claims.
Mr. Levin said Medicare and its contractors shared responsibility for “this taxpayer rip-off.”
About 2,500 doctors who died before 2003 “still had active identification numbers” in May of this year, Mr. Levin said.
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